Health Care - Reality Check

After getting really some email forwards pushing false information and seeing the level of distortion involved in the health care 'debate", which is more a one sided rant in most media outlets, I felt compelled to write something... I'll try not to belabor this, but there are some important points the noise machine is trying to drown out.

Of course the "death panel" malarkey has been exposed as lies to the degree that even major media has reported it as such. Nevetheless I have to start there and am immediately reminded of two things: First, a study (Persistence of Myths : http://www.washingtonpost.com/wp-dyn/content/article/2007/09/03/AR2007090300933.html ) that shows that even when people become aware they've been told a lie they still later remember and believe the lie that they heard first rather than the corrections that follow. Second, Dean Baker's post today (Crazed Health Care Rants : Blame the Washington Post : http://www.truthout.org/081009A )reminds us that even the superficially "responsible" or "balanced" media is to a great degree responsible for propounding confusion by pushing lies out as fact without bothering to check the truth.

The biggest issues in all this are the corporate interests that have unlimited funds to protect their continuing ability to rob the public, backed by the ideology they cultivate that says the government shouldn't do anything at all and can't do anything right if it does. Some suggest that's in many ways a self-fulfilling prophecy since those who espoused that ideology created many spectacular failures while were running the government, but that's another post.

There is certainly a major moral issue in euthenasia/denial of coverage as was falsely clamored about, but that's of course not at all what the health care reform bills are about or contain. Trying to turn the focus to any hint of that is just a way to whip up fear and hysteria. What I don't get about that argument at all though is that right now decisions to deny coverage are made by the insurance companies. I'm far less comfortable with insurance companies deciding (based on their profitability) or employers deciding (based on what level of coverage they want or are able to pay for), than I am with having the limits of coverage be a legal function.

It is clear opponents of this bill don't want open debate and discussion of it. They assume their audience won't read it and basically urge them not to (so they can spin tales about it without being bothered by the facts). This allows them to more easily nitpick a few questionable or blatently false interpretations out of context to whip up a frenzy.

Thus they don't talk at all about all those who have no insurance or health care (and how much their use of emergency rooms when they get ill costs those who do have insurance). They don't talk about those who can't afford insurance (if they even have any option to get it). They don't talk about those trapped in jobs they don't like just to keep their coverage. They don't talk about those who can't start a business or work for themselves because they'll lose coverage and not be able to get a replacement. They don't talk about losses of coverage if people choose to or have to move from one area to another, or the difficulties in getting insured care when traveling or away from your local insuror's "network". They don't talk about all those denied any coverage at all (pre-existing conditions). They don't talk about those losing coverage when they lose their jobs (many, many millions now) who can't get another job (many of whom are also well into middle age or elderly, but not yet old enough for Medicare). They don't talk about the existing insurance cartels where only one or two insurers really serve any given geographical area (which is fundamentally uncompetitive and breeds higher prices). They don't talk about the insurance companies 20% annual rate increases (nothing else goes up 20% a year) that mean the shrinking number of employers that do provide insurance can't afford to offer good plans (or any plans) much longer. They don't talk about the millions of people who have been bankrupted by medical costs (medical debts are actually the leading cause of personal bankruptcy in the US). They don't talk about how our current employer based system makes the US fundamentally uncompetitive in the global economy because we're the only country that still has this crazy system (so our employers have huge costs no other country's employers do).

The current insurance system will actually collapse soon from its cost, or become another privilege reserved only to the wealthy (which works fine for insurance companies since that's who they want to insure anyway: the wealthy can pay the ridiculous rates, and being in better health than the poor or working class therefore will also cost the companies less in claims expense).

So instead of talking about any of the real problems the opponents spread lies and rumors, create diversions and want to talk about some obscure interpretation of how a recommendation made in England might possibly be relevant to some clause somewhere in a draft of the bill. If that narrow item is an issue then why not fix that clause in the bill instead of throwing the baby out with the bathwater?

They are also objecting by suggesting this bill will somehow make assisted suicide easier, though I doubt any insurance company objects to that practice either (they won't pay for it, but certainly wouldn't stop it).

I also don't understand what the issues of the elderly have to do with anything in the bill either (other than scaring the elderly about health care reform scares the politicians since it is generally accepted that the elderly disproportionately vote and are more active in the political process). They're already covered by an existing government plan. Insurance companies won't insure anyone over 65 (leaving aside Medicare supplemental policies, many of which are rip-offs and all of which are very clearly limited in any potential liability to the insuror). Insurance companies also wouldn't insure anyone over 65 even if they could because the likelihood of claims rises exponentially, so they leave it to the goverment to deal with them through Medicare. It also turns out that seniors really like their government plan (and are probably far more satisfied with their Medicare than non-seniors are with their insurance or lack of insurance - I haven't looked for the polls to compare, but I do remember the rate of those in Medicare that were pleased with it was very high).

I'm sure there are some issues with this bill (as with any). The original goals may be compromised (intentionally or unintentionally) in the legislative process, but I think everyone is entitled to:

* Stable coverage they can count on (not tied to staying at a specific job or continuing to live in a specific region and not changing or becoming your cost instead of the employers when the employer can't afford a plan anymore).
* Affordable options for coverage, even when losing or changing jobs.
* Affordable options for coverage for self-employed and small businesses.
* No denial of coverage if you get sick or have a "pre-existing condition" or reach the "lifetime or annual limits" of your coverage.
* No limitations of coverage or treatment.
* If someone legitimately can't afford insurance, they’ll get help with their premiums.
* People will have peace of mind they can always get the care they need, when they need it, from the doctor they choose.

Even people who have insurance now don't have this. Some argue almost everyone with insurance doesn't actually have insurance since if they lose their job they don't (their employer has the insurance).

A public option will be essential to ensure this happens. The insurance companies have absolutely no interest in covering everyone. Their business model is constructed on excluding the "high-risk" or potential non-payers from coverage ("high-risk" also means individuals like the self-employed since the companies have no way of assessing the likely cost they'll incur in claims from any single individual). Those millions of people wind up being left on their own or (for anything major) to the government (or all of us indirectly through ER's). We (and the government) are thus already paying for them AND at the same time subsidizing the profitability of the insurors (by allowing them to select only low-risk customers).

Whether we get something like what we deserve depends on what people do and how much pressure is applied to the politicians. Doing nothing will ensure that we won't get anything and will all gradually (or very suddenly) lose whatever we may have. There was a reason states had to pass laws to require insurance companies to cover breast cancer screening, ob/gyn care, etc., etc., and why federal and state laws had to be passed to require insurers to continue to cover terminated employees (but only if ex-employees could afford to pay the premiums themselves).

My concerns are everyday things like:

One of my near relatives is self-employed. She was in an accident a while back that blew out her discs (and even though employed got treatment then only because of other insurance, the employer didn't offer any). She had surgery but the disc(s) recently blew out again for no apparent reason (she still doesn't know exactly the extent of the issue this time, other than that she can barely walk). When it first happened she couldn't even walk at all and they took her to an emergency room, who refused to give her an MRI or any substantive treatment because she didn't have insurance (even though hospital doctors are not supposed to know the insurance status of the patient, and even though her mother is a nurse in that very same hospital).
There's only one doctor in the entire state (200 or so miles away) that will take on this sort of problem under a state program for the uninsured and of course she has to wait over a month just to get an initial appointment with him (I'll bet he's busy). She's only 20 or so now and one way or another will have to deal with this the rest of her life. It's unconscionable that in this country anyone should have to go through this sort of treatment and live in doubt the rest of their lives over whether they'll get any appropriate treatment in the future. We can do better and she deserves better.

A relative works two jobs (both part-time as employers game the system to ensure no one is full-time and thus eligible for benefits). One of those jobs is public sector but she can only get health insurance through the private employer. The plan they offer is poor (low coverage, high cost, high deductible) and would actually cost her most or all of her usual paycheck to get. She's worked most of her life and has no insurance and few benefits. Again we can do better and she deserves better. As she says "I'll know health care is fixed when I have insurance."

People in this country should not have to live like they're in the Third World (since anywhere else in the world other than there and here they'd actually have permanent, portable coverage). This is a problem for a lot more than just the poor or unemployed (though many of the unemployed were decidedly well-employed middle or upper class only a few months, or years, ago).

I'd think enough people have been through (or are close to someone who has been through) this sort of thing that they would realize we need a solution. Support for reform was high and remains high for the goals above.

My yardstick is the insurance and drug companies hate this bill and are going all out to kill it (paying lobbyists millions a day, giving millions to individual politicians, buying media, lying about the content to whip up a frenzy, and organizing people to disrupt public discussions of the facts).

There are reputable places to go to get the facts and summaries of the bills/proposals (there are still several bills being worked on), but most people don't know, or don't care, to look there (or can't find it in the haystack of total cr*p being pushed out there.

We collectively have a huge problem that will only get bigger. Lies and speculation definitely will not solve it. The run of the mill major media will not properly inform us. We deserve better but need to arm ourselves with the real facts to get it.